Services

Neurological conditions and diseases our physicians treat:

Alzheimer’s disease

Amyotrophic lateral sclerosis (ALS)

Multiple sclerosis (MS)

Chronic pain

Back pain

Bell’s palsy

Carpal tunnel syndrome

Giant cell arteritis

Guillain-Barre syndrome

Headaches and migraines

Movement disorders

Myalgia / myositis

Myasthenia gravis

Myopathies

Neuropathy (and polyneuropathy)

Radiculopathy

Parkinson’s disease

Seizures (epilepsy)

Vertigo

Stroke

Tumors (of the nervous system)

Essential tremors

Fibromyalgia

Dementia

Common symptoms of neurological conditions include:

Back, neck, arm, or leg pain

Seizures

Tremors

Tinnitus

Syncope – fainting

Headache

Difficulty walking or pain while walking

Numbness in hands, feet, arms, or legs

Urge to move legs while resting

Stiffness

Difficulty getting up from sited position

Falls

Memory loss

Poor concentration

Disorientation or confusion

Getting lost in familiar places

Not recognizing family members

Agitation

Loss of consciousness

Abnormal limbs movement

Unusual sensation

Head trauma

Dizziness

Vertigo

Imbalance

Ringing/noise in the ears

Hearing loss

Popping sensation in the ears

Treatments for neurological conditions:

We provide multimodality care including medications; counseling; different aspects of physical therapy such as vestibular rehabilitation and acupuncture; botulinum toxin for chronic neck pain, headaches, excessive sweating, and cosmetic purposes. In addition, we offer the following for treating headaches and chronic pain conditions:

For headaches, we offer magnesium infusion (natural mineral which prevents headaches) once a month, with no side effects

B complex infusion for fatigue and daytime sleepiness

B complex and magnesium injections for fibromyalgia, chronic pain syndrome

Botox for headaches, stiffness in the arms (spasticity after stroke), and excessive sweating

Trigger point muscle injections for neck pain (steroids with lidocaine)

Diagnostic studies we perform in the office include:

Electromyography (EMG) and Nerve Conduction Studies

Nerves control the muscles in the body using electrical impulses. Whenever a muscle contracts (tenses up) in response to a signal from the brain, it also produces an electrical discharge of its own. Electromyography (EMG) measures the electrical discharge made by the muscle. Nerve conduction studies (nerve conduction velocity or NCV) measure how well individual nerves can transmit electrical signals.

Measuring the electrical activity in muscles and nerves can help detect the presence, location, and extent of diseases that can damage muscle tissue (such as muscular dystrophy) or nerves (such as amyotrophic lateral sclerosis). In the case of nerve injury, the actual site of nerve damage can often be located. EMG and nerve conduction studies are often done together to provide more complete information.
Office-based / Routine EEG

Electroencephalography (EEG) records the electrical activity of the brain. Sensors (electrodes) are attached to your head and connected by wires to a computer. The computer records your brain’s electrical activity on paper as wavy lines. Certain brain abnormalities can be detected by observing changes in the normal pattern of the brain’s electrical activity. The routine in-office EEG provides a 20- to 40-minute sample of brain electrical activity.
Ambulatory Electroencephalogram (EEG)

In some patients, such as those with epilepsy, an office-based EEG may appear normal. To aid in the diagnosis of epilepsy, we typically perform an ambulatory EEG with 24 to 48 hours of video recording for continual monitoring. Monitoring patients while they are both awake and asleep can help identify seizures, determine the type and frequency of seizures, and evaluate the effectiveness of epilepsy medications.
Evoked Potential Tests (BAER/VER)

Evoked potential tests measure electrical activity in certain areas of the brain in response to stimulation of certain groups of nerves. These tests are often used to assist in the diagnosis of multiple sclerosis (MS) because they can indicate problems along the pathways of certain nerves that are too subtle to be noticed or found during a doctor’s exam. Problems along the nerve pathways are a direct result of the disease. The demyelization causes the nerve impulses to be slowed, garbled, or halted altogether.
Electronystagmography (ENG) (Vestibular Testing)

Electronystagmography (ENG) is done to help determine whether damage to the structures or nerves in the inner ear or brain is causing dizziness or vertigo. ENG involves a series of tests that evaluate how well the eyes, inner ears, and brain help a person maintain balance and a sense of position (such as being able to distinguish standing up from lying down).

Electronystagmography measures certain involuntary eye movements called nystagmus. These eye movements occur normally when the head is moved. However, spontaneous or prolonged nystagmus may be associated with certain conditions that affect the nerves or structures of the inner ear or brain.
Transcranial Doppler and Carotid Doppler

A transcranial Doppler ultrasound sends sound waves through the skull (cranium) to measure the speed of blood flow to your brain. When an artery or vein that carries blood to your brain is narrowed, blocked, or damaged, your brain may not get enough blood and oxygen, which can lead to an embolism, hemmorhage, or other cerebrovascular disease. Similarly, a carotid Doppler ultrasound checks blood flow in the vessels at the base of the neck (carotid arteries) that supply blood to the brain. It is performed to evaluate the risk of stroke.